Langley House

Langley House is registered to provide care and accommodation to up to 12 people with a learning disability. Langley House is split into three different homes all sharing the same grounds. People receive support from one staff team and all people have access to the main house. At the time of this inspection there were 11 people using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good

Recruitment, staffing, medicine management, infection control and upkeep of the premises protected people from unsafe situations and harm.

Staff understood their responsibilities to protect people from abuse and discrimination. They knew to report any concerns and ensure action was taken. The registered manager worked with the local authority safeguarding adults team to protect people.

Staff were trained and supported to be skilled and efficient in their roles. They were very happy about the level of training and support they received and showed competence when supporting people.

The premises provided people with a variety of spaces for their use with relevant facilities to meet their needs. Bedrooms were very individual and age and gender appropriate.

Staff promoted people’s dignity and privacy. Staff provided person-centred support by listening to people and engaging them at every opportunity. Staff were very kind and caring and people using the service were calm.

Support plans were detailed and reviewed with the person when possible, staff who supported the person and family members. Staff looked to identify best practise and used this to people’s benefit. Staff worked with and took advice from health care professionals. People’s health care needs were met.

People had a variety of internal activities (such as art and craft) and external activities which they enjoyed on a regular basis.

The registered manager ran a well organised service. Relatives’ views were sought, and opportunities taken to improve the service. Staff were supervised, supported and clear about what was expected of them. Audits and checks were carried out in-house, so any problem could be identified and rectified.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidelines. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Further information is in the detailed findings below

This inspection was unannounced and took place on 7 June 2016.

Langley House is registered to provide care and accommodation to up to 12 people with a learning disability. Langley House is split into three different homes all sharing the same grounds. People receive support from one staff team and all people have access to the main house. At the time of this inspection there were 11 people using the service.

There was a registered manager at the home who had the qualification, skills and knowledge to manage the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

The last inspection of the home was carried out in July 2014, there were no concerns raised at that inspection.

The registered manager was appropriately qualified and experienced to manage the home. They had experience of supporting people with learning disabilities and continued to develop further skills and knowledge by on going training. The registered manager had managed the home for six years. The registered manager and deputy manager were available throughout the inspection.

Staff had a clear understanding of what may constitute abuse and how to report it. All were confident that any concerns reported would be fully investigated and action would be taken to make sure people were safe. Safeguarding information posters were displayed throughout the home to ensure people, relatives and visitors and staff had access to information on how to raise issues outside the service if they wished.

Risks of abuse to people were minimised because the provider had robust recruitment procedures in place. Before commencing work all new staff were checked to make sure they were safe to work with vulnerable adults. These checks included seeking references from previous employers and carrying out disclosure and barring service (DBS) checks. The DBS checks people’s criminal records history and their suitability to work within the service.

There were sufficient staff to keep people safe. People received one to one staffing to meet their needs in a relaxed and unhurried manner. For example activities were put in place to support people to focus their anxieties into positive actions and outcomes which reduced incidents for people which could be challenging for staff. Risk assessments were in place to enable people to maintain their independence with minimal risk to themselves and others.

Care plans were personalised to each individual and contained information to assist staff to provide care in a manner that respected needs and individual wishes. Each member of staff knew the person they were supporting well. One member of staff told us, “I used to be a little worried about supporting some people due to their behaviours, but since I have read the care plans and have got to know people, I am more confident and love working here”. Daily records showed that staff had carried out the care and support in line with the person’s care plans.

People, relatives and staff and professionals involved in the home were complimentary about the service and spoke highly about the registered manager and deputy manager. One relative informed us, “Staff are brilliant”. Another said, “We are happy, with the support provided, the manager is very professional.” One professional involved with the home told us, “I find staff and management very reflective, and recommendations I provide are put into practice as asked”.

People were supported to have a sufficient amount to eat and drink. Menus were available for people to see what was for dinner in pictorial format on notice boards in the dining room and the entrance of the kitchen area. Staff had received training and had the skills required to support people who needed a specialist diet or needed to be supported with nutrition in a specific way. People were able to access drinks and snacks when they required them.

Safe systems were in place to protect people from the risks associated with medicines. Medicines were managed in accordance with best practice. Medicines were stored, administered and recorded safely. Health professionals were routinely involved in supporting people with their health and wellbeing.

Staff made sure people with sensory needs received the care they needed to remain as independent as possible. The home had sensory areas inside and outside which were easily accessible to all living at the home.

Below is a summary of what we found. The summary describes what the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We were unable to ask people who lived in the home if they felt safe as they were all unable to communicate with us verbally.

On the day of our visit two people were subject to DoLS and the registered manager had made a further two urgent DoLS requests. We observed that the appropriate procedures had been followed and best interest assessments had been recorded.

All the staff we spoke with demonstrated an understanding of policy and procedure regarding safeguarding, the Mental Capacity Act and DoLS.

We observed that people had been cared for in an environment that was comfortable, unhurried and relaxed.

There were enough staff on duty to meet the needs of the people living at the home and staff we spoke with told us they felt confident the training they had received enabled them to do a good job in caring for people and understanding and interpreting their needs.

Policies and procedures were in place and risk assessments had been conducted for all people living in the home.

Is the service effective?

It was clear from what we saw and from speaking with staff that they understood people's care needs in detail and that they knew them well. Staff had received training to meet the needs of people living in the home.

The personalised care plans and comprehensive risk assessments we looked at suggested that care was both considered, personalised, highly detailed and effective.

Is the service caring?

We observed people being supported by kind and attentive staff. People were treated with dignity and respect. We observed people being given time to do things in an unhurried and calming environment.

We observed staff responding to non-verbal gestures in a way that demonstrated their understanding of the individual they were caring for.

Is the service responsive?

The records that we looked at confirmed people's interests, preferences, dislikes and personal history. Care and support had been provided that met their wishes. People's choices were respected. People had access to activities that they enjoyed and were supported to maintain family relationships.

Is the service well-led?

A manager was in place who was registered with the commission. Quality assurance processes were in place. Staff received regular support and training. We observed a variety of policies and protocols to ensure the safety of people living in the home.

Staff had an in depth understanding of the people they cared for and were able to interpret non-verbal behaviour with good effect. Staff told us they were clear about their roles and responsibilities and felt they were able to express their views.